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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500492
Report Date: 10/30/2023
Date Signed: 10/30/2023 11:43:25 AM

Document Has Been Signed on 10/30/2023 11:43 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:TAPIA-AGUINIGA, ANAFACILITY NUMBER:
394500492
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 2DATE:
10/30/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:32 AM
MET WITH:Ana Tapia- Aguininga TIME COMPLETED:
12:00 PM
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On October 30, 2023, Licensing Program Analyst (LPA) Stacey Williams met with Licensee, Ana Tapia-Aguiniga for an unannounced annual one-year inspection. During the inspection LPA Williams observed (2) two children in care being supervised by the Licensee. All individuals subject to criminal background review have obtained a criminal record clearance. Hours of operation are from 7:00AM-6:00PM. Licensee stated that she does not provide overnight care.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.



The home is single story and the off-limits areas include: Bedroom # 2, # 3 (master bedroom), Bathroom #2 inside master bedroom, Kitchen, hall closet, Laundry room, garage, front yard, left and right side area of the backyard and driveway. The Licensee stated that there are no weapons in the home. There are no bodies of water on the property. Licensee stated there is one pet hamster in the home that does not interact with childcare children.. The backyard has a trampoline that does not have netting. The Licnesee stated that childcare children do not utilize the trampoline. There is also a hammock in the backyard that is not utilized by childcare children per Licensee.

A health and safety inspection was conducted in the areas accessible to children. The house has a working telephone, fully charged fire extinguisher, smoke detector and carbon monoxide detector that meet regulations. LPA observed all the required postings in an area visible to authorized representatives. LPA observed all poisons locked with a key lock or combination lock. There is a fireplace in the facility that is barricaded and not in use.

Report continues on LIC809C................
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE: DATE: 10/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/30/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: TAPIA-AGUINIGA, ANA
FACILITY NUMBER: 394500492
VISIT DATE: 10/30/2023
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After review of the facility files, LPA found that Licensee has all immunization records, Mandated Reporter Training, and an EMSA approved CPR current. CPR expires: 5/2025. Mandated Reporting Training is current. The Licensee understands that these trainings must be complete every two years. LPA observed that all children's files contained appropriate documentation. Immunization records were in child files. Children's roster and a fire drill log were observed; the last drill was conducted 9/2023.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.




LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Exit interview conducted and report was reviewed with the Licensee. During the exit interview, the Licensee, Ana Tapia-Aguiniga confirmed that there are no Registered Sex Offenders living in the facility.

A Notice of Site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. No deficiencies were cited during today’s inspection.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2023
LIC809 (FAS) - (06/04)
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